Management of recurrent rectal cancer: A population based study in greater Amsterdam
AIM: To analyze, retrospectively in a populationbased study, the management and survival of patients with recurrent rectal cancer initially treated with a macroscopically radical resection obtained with total mesorectal excision (TME). METHODS: All rectal carcinomas diagnosed during 1998 to 2000 and...
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Published in | World journal of gastroenterology : WJG Vol. 14; no. 39; pp. 6018 - 6023 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Presently at the Erasmus Medical Center, Rotterdam CE 3015, Netherlands
21.10.2008
Department of Surgery, Academic Medical Centre, Amsterdam AZ 1105, Netherlands%Comprehensive Cancer Centre Amsterdam, Amsterdam CX 1066, Netherlands%Department of Surgery, Free University Medical Centre, Amsterdam HV 1081, Netherlands%Department of Surgery, Academic Medical Centre, Amsterdam AZ 1105, Netherlands The WJG Press and Baishideng |
Subjects | |
Online Access | Get full text |
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Summary: | AIM: To analyze, retrospectively in a populationbased study, the management and survival of patients with recurrent rectal cancer initially treated with a macroscopically radical resection obtained with total mesorectal excision (TME).
METHODS: All rectal carcinomas diagnosed during 1998 to 2000 and initially treated with a macroscopically radical resection (632 patients) were selected from the Amsterdam Cancer Registry. For patients with recurrent disease, information on treatment of the recurrence was collected from the medical records.
RESULTS: Local recurrence with or without clinically apparent distant dissemination occurred in 62 patients (10%). Thirty-two patients had an isolated local recurrence. Ten of these 32 patients (31%) underwent radical re-resection and experienced the highest survival (three quarters survived for at least 3 years). Eight patients (25%) underwent non-radical surgery (median survival 24 rno), seven patients (22%) were treated with radio- and/or chemotherapy without surgery (median survival 15 mo) and seven patients (22%) only received best supportive care (median survival 5 too). Distant dissemination occurred in 124 patients (20%) of whom 30 patients also had a local recurrence. The majority (54%) of these patients were treated with radio- and/or chemotherapy without surgery (median survival 15 mo). Twenty-seven percent of these patients only received best supportive care (median survival 6 mo), while 16% underwent surgery for their recurrence. Survival was best in the latter group (median survival 32 mo).
CONCLUSION: Although treatment options and survival are limited in case of recurrent rectal cancer after radical local resection obtained with TME, patients can benefit from additional treatment, especially if a radical resection is feasible. |
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Bibliography: | R735.3 Rectal cancer Relative survival 14-1219/R Local recurrence Rectal cancer; Total mesorectal excision;Local recurrence; Relative survival Total mesorectal excision ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Author contributions: Bakx R and Visser O contributed equally to this work, wrote the manuscript, analyzed the data and designed the research project; Josso J was responsible for the data-collection; Meijer S and van Lanschot JJB designed the research project and corrected the manuscript. Correspondence to: Dr. Roel Bakx, Academic Medical Center, Department of Surgery, Meibergdreef 9, G4-137, Amsterdam AZ 1105, Netherlands. r.bakx@amc.uva.nl Telephone: +31-20-5669111 Fax: +31-20-6914858 |
ISSN: | 1007-9327 2219-2840 |
DOI: | 10.3748/wjg.14.6018 |